Is estimating maternal mortality useful?
Pierre Buekens1 In this issue, Hill, AbouZahr & Wardlaw (1) present new estimates of maternal mortality for 1995. They have carefully adjusted the data for underreporting, and used statistical models in countries lacking relevant data. They have obtained a global estimate ranging from some 303 000 to 822 000 maternal deaths. This very large range is mostly the consequence of the limited quality of available data. In only 17 countries were the data based on Reproductive Age Mortality Study (RAMOS), one of the best methods to measure maternal mortality. Many country-specific estimates presented by the authors are based on assumptions that are generally conservative. For example, they mainly used an adjustment factor of 1.5 to estimate maternal mortality ratios in 48 countries with a good registration system, including the USA. However, the number of maternal deaths in the USA could be more than twice as high as the reported number (2). The estimates presented here might thus be lower tha
